This true or not?

[AAAhmed46]

http://news.independent.co.uk/world/asi ... ory=640070

How accurate could this be? Im suspicious.....

[MikeK]

I can't read it bro. Do you have the entire article that you can post?

[IJ]

Can't see it either, but i wonder how a press that got excited about Koran abuse would pass this up if it was credible. Tho, we all know its not out of the question that someone died during torture.

[AAAhmed46]

I cant read it either anymore, i think it was taken out or something.

[Panther]

Lots of people have died during torture while this war has raged...

I can see quite a number of them in my mind. I remember the videos of them pleading for their lives and later hearing about their be-headed bodies being found.

I'm not making light of the abuses that may have occured to prisoner enemy combatants by our side, but the truth is we're dealing with folks that just don't have any respect for innocent lives at all. I just think that needs to be kept in mind when worrying about those who are not innocent being held and questioned.

I don't agree with torture and I don't agree with Dershowitz about a "Torture Warrant", but to be honest, I don't know what the answer is.

[Mark Weitz]

Hello everyone, I haven't posted in a while as I've been very busy and I don't think I've posted on one of Panther's threads before.

As we've all read many times before, torture is a very poor tool to extract information as people will tell you anything you want to hear to get the torture to stop. I don't care what euphemisms are bandied about; torture is torture pure and simple and I don't buy the lame, Orwellian nonsense of re-labelling it as a "stress position" or some other rediculous term that insults people's intelligence.

Torture does work very well, at least many torturers believe, however, for one specific purpose - to break the spirit of the person being tortured and those close to that individual, which is why many people that are tortured are often given this treatment in the presence of their spouses and children. It is doubtful, however, that torture or any other brutal treatment of prisoners is going to accomplish anything given the intense hatred of America by many in the Muslim world and the fervour and commitment they bring to their insurgency.

Panther, you ask the $64,000.00 question,

but to be honest, I don't know what the answer is.

As far as torture goes, far more would be accomplished by simply not doing it. Don't do it, it's that simple. If you torture then you lower yourself, at least in that specific behaviour, to the level of those you claim to despise. Torture is ALWAYS a war crime and a severe human rights violation and this does not change depending on who is doing the torturing. If you want to have political currency with the people whose country you've invaded, I'd guess one of the worst things you could is commit crimes that were commonplace for the brutal dictator you just got rid of. Don't do what dictators do and you won't be lumped in with them. Torture, and you're instantly committing a war crime and throwing butane on an already incediary situation.

Mark

[Panther]

Mark, welcome to the Tough Issues forum. Everyone gets the same welcome and request to read and folllow the forum rules, but knowing that you're a regular poster on other forums here, I'm not worried about any problem... so... Thanks for posting.

It's true, I don't know the answer. But let me be specific on the question I don't know the answer to... I don't know how to extract information from someone reliably. There are just so many problems with it, not the least of which is whether the person really knows the information, whether the information they know or tell you is accurate and reliable, or whether this is even the right person in the first place? Certainly some of those things can be mitigated to a greater or lesser degree, but most organizations like this are setup in a manner where information is limited to what the person needs to know about their small part. So, even if information is obtained it is questionable about just how valuable such information will be. Contrast that with absolutely knowing that using torture to gain that information will generate more hate and animosity towards us should be enough of a reason not to use torture that such "theoretical debates" as Dershowitz has started... well that debate simply shouldn't have been started. As you point out, we're above that and the only way the world is going to know that we're above that is by not doing it in the first place at all.

The question that I do know the answer to is whether we should use torture or not. Looking back at my previous post, I think perhaps that I was not clear enough. The answer to that is a resounding NO!

I don't want to face that type of decision (meaning "do I tell them what they want to hear even though it isn't the truth just to stop the torture or do I maintain the truth that I don't know what they're talking about and have the torture continue?") and since it is a basic human Right granted to each of us by our Creator, then I don't want anyone else to face that decision either. (And no, I haven't done anything that would make me a target of being labelled an enemy combatant, but history is filled with innocent citizens who have been persecuted, targeted, and even executed by their own government for various reasons... regardless of claims to the contrary, folks in the U.S. need to be careful because there are a LOT of things that are happening in the name of "more security" and "the war on terror" than I think the vast majority of people realize.)

[Mark Weitz]

Hi Panther and thanks for your reply. I did understand in your first post on this topic that you're opposed to torture. As for Dershowitz, he's gone off the deep end. Yes, hes a Harvard prof, at least last time I checked, and he's regarded as a scholar on matters of international law. That being said, he's also gone off the deep end. I saw him interviewed on a news show here in Toronto and he was making the case for torture and I have to say I thought that for a man of his intellect and knowledge it was a lame and rediculous argument. And arguments for human rights abuses are always lame regardless of the credentials of the person making them. Dershowitz is, understandably, very angry and outraged over Palestinian terrorist bombings in Israel. I believe, however, that his own unexamined rage and blood lust for revenge is hijacking his better judgement big time.

I know I said this but I'll say it again, and this is not intended at anyone here, but more a point of discussion - If you despise terror, hate, war crimes, unlawful abuse and killing, then for G_d's sake the last thing law-abiding citizens and states should do is adopt the same ghoulish tactics as the oppressor as you make yourself what you despise. This is, unfortunately, a point lost on W's administration and it is hurting Americans by inciting greater hatred and vengeance from those in the Muslim world who read the news and are tomorrow's would-be terrorists.

Mark

[Bill Glasheen]

Role of devil's advocate = begin

This is, unfortunately, a point lost on W's administration and it is hurting Americans by inciting greater hatred and vengeance from those in the Muslim world who read the news and are tomorrow's would-be terrorists.

Why? Because you said it's so?

We're buddies online, Mark, and I'm not worried about challenging your thinking.

What I want you to do is realize the degree to which you're buying into and propagating the false propaganda of a group of people who have no issues with the most extreme torture and public slaughter even of innocent parties.

What I want you and others to do is to think more carefully about what's going on here. In this relatively open society with a relatively free - if not responsible - press, we get the isolated, gray-area cases blown out of proportion as a tip-of-the-iceberg norm. What you really see when you look with objective eyes is something quite different. We've lost no detainees to questioning that I know of, even though we've actually lost interrogators to detainee violence (in Afghanistan before Gitmo was constructed).

First... In Gitmo, Geneva Convention rules do not apply. What rules SHOULD apply is a different story. And yes, we have an image problem here. Yes, perceptions matter. Yes, GW needs to pay attention.

Second... I think the most important thing Dershowitz was doing is calling attention to the fact that ALL countries DO engage in gray-area interrogation techniques. What he was/is proposing is calling a spade a spade. Just as you need a search warrant to invade someone's home (violating the Bill of Rights), so you should need a warrant to do anything more than have a casual conversation with a detainee.

The goal of the warrant would be to reduce and limit the amount of torture that would, in fact, be used in an emergency. This is an issue that should be discussed now, before we confront the emergency.

So, let the debate begin.

- Alan M. Dershowitz

As technology (interrogation techniques) improve - and they will with modern pharmacology and interactive brain function assessments - we need to put on our ethics hats and ask what the responsible use is of said technology. For instance in psychiatry, what was once an obvious abuse (One Flew Over the Cuckoo's Nest electroshock therapy) is now a viable, humane, evidence-based medical intervention (barely measureable electric therapy that changes neurotransmitter levels). When interrogation techniques reach that level of sophistication, then what?

I don't quibble with your perception that Dershowitz may be negatively affected by Palestinian-related homicidal violence. On the other hand if you want to know what life may be like in the future, maybe it's time to talk to those (e.g. the Israelis) who survive in spite of dealing with it on a daily basis. Somewhere, somehow, our own self preservation and our own studied and thoughtful dealings with ethics needs to rise past the politics and the propaganda. It does no good to be right if as a nation you are dead right.

These are difficult times. IMO, it's time to start and continue the open debate. Let's not pretend none of this stuff goes on in YOUR back yard. (You in the general sense, Mark) We glorify it in Holllywood when the good guy (Arnold, Mel, Clint, Will, etc.) roughs up the criminal a bit to get that precious piece of information to save the world from the bad guys and aliens. But when someone's A/C function in their cell is less than optimal, we are shocked - shocked, I tell you!

That's bullschit.

Can't we have an intelligent discussion about the topic of intelligence extraction? Or like the soldiers who regularly schit and piss their pants, are some facts of love and war just not discussed? And are we to expect six-sigma performance of our prison and detainee systems in the middle of a war? What is realistic?

Role of devil's advocate = end

- Bill

[Mark Weitz]

Bill, you never fail to get the debate moving forward, and I mean that sincerely and in a positive way. So to respond,...

Why? Because you said it's so?

I don't think I'd ever say something would happen in the world simply because I said so. My opinion is just that. I believe what I say and I'm willing to accept that I could be as wrong as a three dollar bill, and to be perfectly honest, I hope I am wrong because I don't take human life lightly.

What I want you to do is realize the degree to which you're buying into and propagating the false propaganda of a group of people who have no issues with the most extreme torture and public slaughter even of innocent parties.

Bill, I think you're way off the mark here. There are many people who hold a similar point of view and I'll give one example. You're probably familiar with the term "blowback", a term that is used within intelligence circles that describes the negative effect(s) and/or counter-force that results from a particular policy or strategy. My concern is that there is a potential for blowback in the form of continued insurgency by terrorists against Amercian and other foreign soldiers in Iraq as a result of the policy of the US, which W sought advice on from his highest legal council, to implement procedures that are politely called stress positions but are more honestly called torture. My guess is that if one asked a victim of so-called stress positions how they would define the experience they would probably call it torture. I repeat myself because I think it's too easy to fall into an Orwellian game of mis-naming torture with some euphemism that IMHO is elephant sh_t. And as much as I think Dershowitz is a crack-pot, I'll give him a mote of credit for at least being honest when I saw him interviewed on television, used the word torture and then proceeded to define his terms carefully as to how to implement torture-light.

Bill, could you please explain exactly how anything I've written on this thread is "buying into and propagating the false propaganda of a group of people who have no issues with the most extreme torture and public slaughter even of innocent parties". My comments opposing torture and condemning those who practice it are unequivocal. I think I have an idea on where you're going with this but I'd rather you spell it out.

What I want you and others to do is to think more carefully about what's going on here

I think very carefully about this issue and read almost every article I can find in several papers that I check on a daily basis. Don't assume a lack of careful thought simply because we disagree on some aspects of this debate.

We've lost no detainees to questioning that I know of, even though we've actually lost interrogators to detainee violence (in Afghanistan before Gitmo was constructed).

You may be factually wrong on this point. There were reports several months back of a handful of deaths in Abu Ghraib.

In this relatively open society with a relatively free - if not responsible - press, we get the isolated, gray-area cases blown out of proportion as a tip-of-the-iceberg norm. What you really see when you look with objective eyes is something quite different.

We can try to look with objective eyes but I think you're being willfully naive on the tip of the iceberg perspective you talk about. Those who practice torture, whether a handful of bad apples or as a matter of policy, are not interested in having it advertised, at least not when you're stated reason for being in a country is to help give birth to democracy and all the rights, privileges and respect for human rights that goes with it. If were seeing a little then there's probably a lot more going on that isn't surfacing. But aside from that, Bill, when the story initially surfaced it was evident that it wasn't just a few bad apples and that these interrogation techniques, or torture, were widespread. Considering that Alberto Gonzalez prepared memos for W to justify torture as acceptable practice shows just how deeply off the rails and unglued W's administration has become on this issue and how the administration sought to enshine torture as a matter of policy, though we see all the Orwellian terminology used and bogus reasons to justify it.

First... In Gitmo, Geneva Convention rules do not apply. What rules SHOULD apply is a different story

Right, another huge problem. Geneva Convention rules should apply and disregard for them is precisely what is smearing the image of W's administration. How about the old rules as a start. We have to get past this idea that somehow the terrorist nightimare that was visited on New York must mean that the US can now dispense with international law and all the treaties to which it is a signatory too. There's simply no credible evidence that dispensing with the Geneva Conventions is going to help one bit and as I've said earlier, dispensing with these conventions will probably worsen the image of the US for many would-be terrorists who are looking for a reason to take up arms, and this is something that must be avoided.

think the most important thing Dershowitz was doing is calling attention to the fact that ALL countries DO engage in gray-area interrogation techniques. What he was/is proposing is calling a spade a spade. Just as you need a search warrant to invade someone's home (violating the Bill of Rights), so you should need a warrant to do anything more than have a casual conversation with a detainee.

I agree that there needs to be more scrutiny on this matter but there a few major flaws with this argument. You're statement that all countries engage in torture is too sweeping a generalization. Yes, many do but as we all know, that everyone is doing it doesn't make it right nor does it mean that we should accept is as fait accompli and find legal means to make it above board. The practice is fundamentally flawed as it is useless for getting accurate information, a point admitted by many within the military and intelligence circles, and more important it is fundamntally a human rights violation that does not cease to be one because the person you're torturing is a terrorist or the torturer is a citizen of a free country. Torture is totally incompatible with any notion of a free society and W is putting a terrible stain on his administration, NOT US citizens, by permitting it and finding bogus legal means through the Office of Legal Counsel to justify it.

There is, however, one very "good" reason to practice torture, which all who practice it are well aware; to break the spirit of the person you're torturing and those associated with him/her. Torture has been widely used as a counter-insurgency tactic, to break the will of the insurgency, and this has been done throughout Central and South America, throughout Asia and the Middle-East. There's no pretence of getting at accurate intelligence. You torture anyone long enough and they'll tell you they slept with Hitler. It's useless for intelligence. It's primary purpose is to break a person psychologically and spiritually, to break their will so they won't continue with what the authorities, those who torture, deem to be bad behaviour. Well, it would be nice if the bad guys stopped their insurgency. Unfortunately, the torturer becomes what he despises when he tortures, commits a war crime and throws butane on the situation by inciting those associated with the victim to get pay-back. And despite W's speeches to the contrary, things are going horribly in Iraq, the insurgency is as strong as ever and will most likely continue. Rumsfeld himself has said he expects this to go on for another two years, which is about as cynical an admission of failure you're getting to get out of him.

As technology (interrogation techniques) improve - and they will with modern pharmacology and interactive brain function assessments - we need to put on our ethics hats and ask what the responsible use is of said technology. For instance in psychiatry, what was once an obvious abuse ( One Flew Over the Cuckoo's Nest electroshock therapy) is now a viable, humane, evidence-based medical intervention (barely measureable electric therapy that changes neurotransmitter levels). When interrogation techniques reach that level of sophistication, then what?

A lot I disagree with here. Technology improvements do not make torture ethical. Obviously, information extraction does that does not involve assaulting a person and putting their health and life in jeopard is acceptable and everyone knows this. If somehow a drug is created that is more effective than sodium pentothal and the injection and after-effects do not constitute torture as it understood in international law then fine. But that is way beyond what we are talking about at present.

You're comment about ECT being a valid evidence-based medical intervention is wrong. First, ECT machines have NEVER been tested by the FDA for either safety or efficacy. Second, almost all ECT outcome studies are mere weeks in duration post treatment. More recent data that addresses lengthier periods post-treatment show that efficacy goes way down and relapse rates go up. Also, almost all studies fail to ask the patient how they feel months after treatment and gloss over the issue of memory loss, something that many ECT recipients report but are often denied by the professionals because it undermines the image of ECT as safe and effective. Your saying that ECT is "barely measurable electric therapy" is untrue. ECT causes the grand-daddy of grand mal seizure, en eletrical storm in the brain that is indiscriminate and not specific to areas of the brain implicated in depression or any other SMI. Also, old ECT, as seen in "One Flew Over..." was pre-anaesthetic. Once they introduced anaesthesia, which was not a bad idea as people often had fractures of the limbs and spine, the seizure threshold went up so they had to give the brain a GREATER shock, not less, to pass the seizure threshold. Bill, I believe you are either an MD or schooled in medicine. You and I both know that there is no therapeutic effect of a grand mal seizure, that most neurologists, except those supporting ECT, go to great lengths to prevent people from having grand mal seizures as they are ALWAYS a risk for brain damage and this doesn't change simply becuase one is depressed. There is no evidence whatsoever to show that inducing grand mal seizures is therapeutic in any sense of the word or that the brains of depressed people are somehow protected against the repeated assault of numerous seizures in a course of ECT. I could go on but I'll end here by saying that ECT is part of the history of brain-damaging therapeutics in psychiatry - and I do not reject all psychiatric treatments BTW - and it properly belongs on scrap heap of bogus and damaging medical treatments.

These are difficult times. IMO, it's time to start and continue the open debate. Let's not pretend none of this stuff goes on in YOUR back yard.

No, it's time to dispense with torture and the pretense that we can somehow find intelligent and nuanced ways to torture to get important information out of people. I don't pretend that my country has never tortured or is not supporting in some manner. But so what? The real intelligence gathering techniques that are use routinely by police and the military are, I'm sure, very fine-grained and effective. And sometimes you don't get what you're looking for when you'd like to. Pretending that we can have a debate about torture, as if there was some merit to it, is preposterous. The sooner it is dispensed with the better. Too much harm has been done and it only makes the bad guys more determined.

A no-brainer to me.

Mark

[Bill Glasheen]

Devil's Advocate Mode = On

Bill, could you please explain exactly how anything I've written on this thread is "buying into and propagating the false propaganda of a group of people who have no issues with the most extreme torture and public slaughter even of innocent parties". My comments opposing torture and condemning those who practice it are unequivocal. I think I have an idea on where you're going with this but I'd rather you spell it out.

That's pretty easy, Mark.

In this last post, you used the word "torture" (or some derivative of it) twenty-seven (27) times. Wow... Your debating technique (see your post) is to describe something a party or parties are doing, and then use the word torture afterwards. The listener then is to assume that the wide net you have cast puts the actions of al Zarqawi slowly carving the head off of a civilian and the actions of a specialist questioning a detainee are morally equivalent. To suggest that there is anything but a dichotomy here is to be guilty of egaging in an...

...Orwellian game of mis-naming torture with some euphemism

Wow!

OK... Now I get it. Torture bad. No torture good. We are a Democracy. We do not torture. Let's all light candles and sing Kumbaya. And then we all can go home and sleep at night.

Only THOSE guys use tourture, after all. Right?

This is EXACTLY the tactic Dick Durban (D-IL) used in Congress recently. He described a detainee whose A/C was too cold one day, too hot another, pissed his pants because he waited in a room to long, and was forced to listen to Christina Aguilara music (which I'll acknowledge is pretty close to torture...). And then he says

If I read this to you and did not tell you that it was an FBI agent describing what Americans had done to prisoners in their control, you would most certainly believe this must have been done by Nazis, Soviets in their gulags or some mad regime — Pol Pot or others — that had no concern for human beings.

And then guess what? Al Jazeera plays his speech on their news programs.

So now it is official; Americans are Nazis. We exterminate Muslims in gas chambers.

Meanwhile, guess what happens afterwards? A week later, Dick Durbin gives the following speech to Congress.

More than most people, a senator lives by his words ... occasionally words fail us, occasionally we will fail words.

I am sorry if anything I said caused any offense or pain to those who have such bitter memories of the Holocaust, the greatest moral tragedy of our time. Nothing, nothing should ever be said to demean or diminish that moral tragedy.

I am also sorry if anything I said cast a negative light on our fine men and women in the military. ... I never ever intended any disrespect for them. Some may believe that my remarks crossed the line. To them I extend my heartfelt apology.

Wow!

You used the term "blowback", Mark. Ya think Senator Durbin experienced any? If so, why?

Do you think Senator Durbin contributed to any "blowback" from his (mis) representation of U.S. policy? Will lives be lost because of his comments? Was there more good done than harm? Did it lead to constructive dialogue?

Meanwhile... Where does the debate go? Do you think that because you and others repeat "torture" literally dozens of times in a response to a request for intelligent dialogue, that less harm will be done? Or to use the thoughts of Grossman describing the reality of combat, is this one of those things (like crapping your pants in battle) that we just won't talk about? And if grandpa never tells his grandson that he browned his britches on the beaches of Normandy, will grandson have better bowel control when he enters this idealist world of the defenders of freedom?

A funny thing happend, Mark, when lawyers in this country started on sanctimonious, money-seeking tirades in the courtroom about "victims" in the workplace. Did you know that Jackie Chan films all his movies in places other than the United States? The plot settings were in this country, and yet he felt compelled to film it elsewhere Why is that so?

If the United States sends detainees or terrorist suspects to other countries for information extraction, will it now be OK? If a tree falls in the forest and nobody is there, did it make any sound?

But of course none of this will happen... We are a Democracy. We don't torture.

By the way, ever experienced a maximum security prison in this country? In any country?

Have you ever been a LEO in the middle of a case where a perp and his cronies continuing to do harm and the safety and welfare of others was in your hands?

Have you even questioned a suspect in a criminal case? Do you know what is allowed and what isn't allowed?

What will happen if new technology of ANY kind suddenly makes information extraction easier and virtually pain free? We already have "truth serum," so don't tell me nobody will go there. When will the discussion of the ethics of said endeavors begin?

Devil's Advocate Mode=OFF

- Bill

[Bill Glasheen]

By the way, Mark, I am neither a psychiatrist nor a psychologist, and I don't play one on TV. However I saw a seminar given by a nationally-reknowned psychiatric researcher several decades back where he was showing data on the newer methods of applying ECT.

ECT is usually administered to patients in a series of treatments, ranging from six to twelve treatments over a two week period. Most of these patients have had no success on antidepressants or mood stabilizing medications.

{snip}

ECT has undergone a complete image makeover in the last twenty years. It has regained respectability. Many psychiatrists now consider it an efficient way to relieve severe depression or to break a manic cycle for the manic depressive. Its success rate, according to the American Psychiatric Association (APA), is 80%, considerably higher than the 50% to 60% success rate of most antidepressant medications. And according to ECT advocates, it can restore a severely depressed or manic patient to health in half the time it takes medication - - sometimes as little as three weeks to reach a therapeutic level.

- Electroshock Therapy

Yes, there are side effects. Can you give me a treatment that doesn't have any?

I mentioned this to make a point, Mark. It seems you helped me make my point.

- Bill

[Mark Weitz]

Bill, I attached here the main findings by a major researcher in the field, Sackeim et al, and in fact Sackeim is connected to a major company in the ECT field, Mecta, so his bias would be towards supporting ECT. However, he found that relapse rates were very high unless the patient continued on a regimen of pharmacoptherapy, which is, in practice, often not done. By itself the efficacy rate often quoted, approximately 80%, is washed out given the high relpase rates Sackeim found. There are other studies as well as authors I could mention and I know, as I've studied psychiatric treatments for years, that of course you will find many studies to support the practice.

Obviously, many medical treatments have side effects but there are a number of issues here. My assertion, that ECT works by inducing seizures, which is a potentially hazardous and risky procedure, is something rarely reviewed in the literature. As someone with medical training and research background, you are qualified to appreciate the effect of seizures on the human brain. Since you didn't respond to this specific point, I'll ask you directly: do you believe that inducing grand mal seizures repeatedly is a healthy thing to do a person's brain? Regardless of whether it works or not, and even Sackeim's study shows it does poorly unless followed up pharmocotherapy, how could a "treatment" that involves inducing grand mal seizures do anything but damage a brain?

Some of ECT's critics, such as Dr. Breggin, Dr. Michael Chavin, Doug Cameron, Dr. Valenstien, say that ECT's actual effect is to produce an organic brain syndrome consistent with closed head injury. One side effect of this treatment is euphoria and since most studies are only weeks in duration immediately following the recovery phase of treatment of course you're going to get symptom improvement because euphoria, an elevated mood state, is a natural byproduct of the treatment. After months however, many of these patients will relapse.

So, quite the contrary, I didn't make your point. Or, more accurately, we each found a study that supports our claims.

Vol. 285 No. 10, March 14, 2001


Continuation Pharmacotherapy in the Prevention of Relapse Following Electroconvulsive Therapy
A Randomized Controlled Trial

Harold A. Sackeim, PhD; Roger F. Haskett, MD; Benoit H. Mulsant, MD; Michael E. Thase, MD; J. John Mann, MD; Helen M. Pettinati, PhD; Robert M. Greenberg, MD; Raymond R. Crowe, MD; Thomas B. Cooper, MA; Joan Prudic, MD


JAMA. 2001;285:1299-1307.

Context Electroconvulsive therapy (ECT) is highly effective for treatment of major depression, but naturalistic studies show a high rate of relapse after discontinuation of ECT.

Objective To determine the efficacy of continuation pharmacotherapy with nortriptyline hydrochloride or combination nortriptyline and lithium carbonate in preventing post-ECT relapse.

Design Randomized, double-blind, placebo-controlled trial conducted from 1993 to 1998, stratified by medication resistance or presence of psychotic depression in the index episode.

Setting Two university-based hospitals and 1 private psychiatric hospital.

Patients Of 290 patients with unipolar major depression recruited through clinical referral who completed an open ECT treatment phase, 159 patients met remitter criteria; 84 remitting patients were eligible and agreed to participate in the continuation study.

Interventions Patients were randomly assigned to receive continuation treatment for 24 weeks with placebo (n = 29), nortriptyline (target steady-state level, 75-125 ng/mL) (n = 27), or combination nortriptyline and lithium (target steady-state level, 0.5-0.9 mEq/L) (n = 28).

Main Outcome Measure Relapse of major depressive episode, compared among the 3 continuation groups.

Results Nortriptyline-lithium combination therapy had a marked advantage in time to relapse, superior to both placebo and nortriptyline alone. Over the 24-week trial, the relapse rate for placebo was 84% (95% confidence interval [CI], 70%-99%); for nortriptyline, 60% (95% CI, 41%-79%); and for nortriptyline-lithium, 39% (95% CI, 19%-59%). All but 1 instance of relapse with nortriptyline-lithium occurred within 5 weeks of ECT termination, while relapse continued throughout treatment with placebo or nortriptyline alone. Medication-resistant patients, female patients, and those with more severe depressive symptoms following ECT had more rapid relapse.

Conclusions Our study indicates that without active treatment, virtually all remitted patients relapse within 6 months of stopping ECT. Monotherapy with nortriptyline has limited efficacy. The combination of nortriptyline and lithium is more effective, but the relapse rate is still high, particularly during the first month of continuation therapy.

[Bill Glasheen]

That's fine, Mark. Medicine evolves. I have no problem with ECT going by the wayside if relapse is always an issue or if better therapy comes about. The big problem here is that - by protocol - ECT is used when other therapies fail. The fact that it works at all (at least temporary relief according to your citation) under such conditions is pretty remarkable.

It takes time to sort these things out, etc. Folks spent a fortune on ABMT for breast cancer only to find out it didn't help. Similar issues have come up with anti-arrhythmia drugs.

But this has nothing to do with the subject except perhaps that it might have been example of something being other than what it appeared to be. It certainly IS an example of an intervention dramatically evolving from the horror that it once was to the controlled environment that it now is performed in. It's certainly less painful and brutal than a CABG, and that medical intervention is a commodity these days.

My assertion, that ECT works by inducing seizures

Actually from what I can tell, folks don't know that.

How Electroshock Therapy might work

What is most incredible is that doctors do not know why ECT actually works to fight mental illnesses, which often makes making a decision to have ECT even more difficult for a patient. It seems so unscientific and remains a mystery. But here are the major theories:

* Neurotransmitter theory. Shock works like antidepressant medication, changing the way brain receptors receive important mood-related chemicals, such as serotonin and dopamine and norepinephrine.


* Anti-convulsant theory. Shock-induced seizures teach the brain to resist seizures. This effort to inhibit seizures dampens abnormally active brain circuits, stabilizing mood.


* Neuroendocrine theory. The seizure causes the hypothalamus, part of the brain that regulates water balance and body temperature, to release chemicals that cause changes throughout the body. The seizure may release a neuropeptide that regulates mood.


* Brain damage theory. Shock damages the brain, causing memory loss and disorientation that creates a temporary illusion that problems are gone. Shock supporters strongly dispute the theory, advanced by psychiatrist Peter Breggin and other shock critics.

Seizures happen as a result of the procedure, but it isn't clear that it's the seizure that causes the relief from major depression. It could be something else, in which case further research could cut to the chase of the matter.

Who knows?

Aspirin was used for generations before the biochemistry of pain and inflammation was figured out. That led to the creation of man-made medications. But that story still isn't over.

- Bill

[IJ]

"In Gitmo, Geneva Convention rules do not apply"

"Why? Because you said it's so?"

Comment?

Tempted to comment on ECT but seems out of place. Will query: if we have "truth serum," why was it national policy to subvert international and national law on torture?

Well, that was rhetorical. It must be that the truth serum doesn't work.

Last question: Is it really possible that Durbin's moronic comments are damaging to our PR, but our own actual excesses do not? You're hard on Durbin and you should be. You seemed to kind of like it when Bush asked Al Qaida to "bring it on," and were forgiving when he called our war a "crusade." And Al Jazeera may be more interested in inflammatory Durbin droppings but there's plenty of legitimate concerns people might have. Given that lack of documented efficacy why risk it?